JD for IT Testing Engineer III (Min 8+ Years of Exp)
Key Responsibilities
• Provide MMIS and QA SME knowledge.
• Prepare and maintain comprehensive test plans, test strategies, test estimates, and test schedules for multiple project phases and functional areas.
• Define and tailor test conditions and approaches to suit specific system/application requirements.
• Track testing progress and prepare testing metrics, status updates, and reports.
• Establish and maintain test environments and appropriate test data for successful execution.
• Participate in root cause analysis in collaboration with development teams to identify and prevent recurring issues.
• Identify, implement, and drive continuous improvement initiatives for testing processes, tools, and methodologies.
• Highlight process improvement opportunities, issues, and risks to stakeholders in a timely manner.
• Manage and monitor the defect management lifecycle during testing phase, ensuring proper documentation, tracking, re-testing, and closure.
• Support the client during User Acceptance Testing (UAT) under the guidance of the Test Lead.
• Coordinate and support training and knowledge transfer for new QA team members,
• Participate actively in test status meetings and project discussions.
• SIT, UAT, E2E testing expertise -6+ years preferred in large scale healthcare systems.
• Strong communication & coordination — Ability to work with vendors, fiscal agents, and cross-functional teams.
JD for IT Testing Engineer II (Min 5-8 Years of Exp)
Key Responsibilities
• Gather requirements and scenarios from Development Team, Business Analyst and other stakeholders.
• Work closely with Project Management Team during design phase.
• Prepare detailed Test Scenario & Test case
• Perform hands-on functional and web UI testing
• Create and maintain test scripts, plans, and cases
• Conduct regression, post-release, and UAT testing
• Identify, document, and track defects to resolution
• Collaborate with developers to ensure software meets business requirements
• Execute SQL queries for bulk test data and update them accordingly.
• Execute Component, Endurance testing for new API services and Load Testing for end-to-end Web application.
• Work on ADO and JIRA for defects.
• Develop, update and maintain quality testing standards and procedures.
• Follow standard testing methodology frameworks.
• Determine and meet time estimates and schedules for testing efforts.
• Preparation of Defect Status Reports and Daily/Weekly Status Reports.
• Work independently as well as work collaboratively in a team environment.
NM CNDS O&M Claims Tester (Applicable for IT Testing Engineer II & IT Testing Engineer III):
Responsible for claims testing for MMIS health care projects. Drive the test strategy and process, domain knowledge, perform analysis of business requirements, designs and develops test plans, ensures quality process, coordinates with customers on delivery and deployments. Works in team environment and provides testing guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in the application and assisting customers in implementation decisions.
1. Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.
2. Candidate should have hands-on experience on claims processing and Adjudication processes.
3. Must have good experience in Reference code/data sets required in Claims adjudication.
4. Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.
5. Should be able to run queries and perform basic system analysis, RCA etc.,
6. Should work closely with the client and development team during the stages of development, and conduct demos at completion of milestone, track and close feedback from such demos
7. Must have excellent written and spoken communication skills. Should be able to multitask between internal team and clients based on priority tasks
8. Work Closely with Dev, architecture and Design teams to define the GUI view and platform requirements, which is the foundation of the product.
9. In depth understanding of Claims and Claims lifecycle:
- Member
- Provider
- Claim submission – Paper and EDI X12
- Adjudication
- Payment Cycle (Finance)
- Reporting
10. Claim Types:
- Professional
- Dental
- Institutional
- Pharmacy
- Encounters and Capitation
11. Claim Formats:
- EDI X12 formats like 837P/I/D
- X12 formats 835, 834, 270/271, 276/277
12. Claim System:
- Familiarity with systems like CMdS, GHS, Facets and etc
Testing knowledge and E2E Testing:
• Validate the entire flow from claim intake to payment and reporting.
• Interface testing - Test integration points between systems
• Design test case based on business rules, coverage policies, and system configurations.
• Familiarity with test management tools like ADO, JIRA,
• Interface/API testing tools like Postman
Technical Skills
- SQL: To validate data in backend tables (e.g., claim status, payment details, find members/providers, Benefit Plan).
- EDI Tools: Validating X12 files.
- Interface Testing: Understanding how data flows between systems and formats and use tools like postman
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